PURPOSE: To describe the predictors of persistent hypotension after carotid artery stent (CAS) placement and define the clinical outcome of patients with this hemodynamic disturbance. MATERIALS AND METHODS: One hundred forty CAS procedures were performed in 133 consecutive patients. Post-CAS hypotension-defined as a greater than 40 mm Hg decrease in arterial pressure without evidence of hypovolemia, with a systolic pressure lower than 90 mm Hg at the end of CAS and lasting at least 1 hour-was observed in 25 patients (group 1); 108 patients did not have hypotension (group 2). RESULTS: Post-CAS hypotension developed in 33.9% of cases after balloon-expandable stent placement versus in 13.6% of cases after self-expanding stent placement (P =.04). In-hospital minor ipsilateral strokes occurred in 16% of cases in group 1 versus in 3% of cases in group 2 (P =.03). There was one (0.9%) major stroke (transient) and three (2.6%) transient ischemic attacks, all of which occurred in group 2 (not significant vs group 1 for both conditions). At 10 months +/- 4 (SD) of follow-up, there was greater total mortality in group 1 than in group 2 (20% vs 4%, P =.02), whereas neurologic events did not differ significantly between the groups. CONCLUSION: Hypotension due to carotid sinus stimulation is frequent after CAS with balloon-expandable stents. This phenomenon correlates with increased in-hospital complications and long-term risk of death.
PURPOSE: To describe the predictors of persistent hypotension after carotid artery stent (CAS) placement and define the clinical outcome of patients with this hemodynamic disturbance. MATERIALS AND METHODS: One hundred forty CAS procedures were performed in 133 consecutive patients. Post-CAS hypotension-defined as a greater than 40 mm Hg decrease in arterial pressure without evidence of hypovolemia, with a systolic pressure lower than 90 mm Hg at the end of CAS and lasting at least 1 hour-was observed in 25 patients (group 1); 108 patients did not have hypotension (group 2). RESULTS: Post-CAS hypotension developed in 33.9% of cases after balloon-expandable stent placement versus in 13.6% of cases after self-expanding stent placement (P =.04). In-hospital minor ipsilateral strokes occurred in 16% of cases in group 1 versus in 3% of cases in group 2 (P =.03). There was one (0.9%) major stroke (transient) and three (2.6%) transient ischemic attacks, all of which occurred in group 2 (not significant vs group 1 for both conditions). At 10 months +/- 4 (SD) of follow-up, there was greater total mortality in group 1 than in group 2 (20% vs 4%, P =.02), whereas neurologic events did not differ significantly between the groups. CONCLUSION:Hypotension due to carotid sinus stimulation is frequent after CAS with balloon-expandable stents. This phenomenon correlates with increased in-hospital complications and long-term risk of death.
Authors: A Tsurumi; S Miyachi; O Hososhima; T Izumi; T Ohshima; N Matsubara; T Kinkori; T Naito; T Wakabayashi Journal: Interv Neuroradiol Date: 2009-04-15 Impact factor: 1.610
Authors: Gokhan Alici; Birol Ozkan; Mehmet Vefik Yazicioglu; Muslum Sahin; Mustafa Bulut; Goksel Acar; Osman Gazi Kiraz; Ali Metin Esen Journal: Clin Auton Res Date: 2012-12-29 Impact factor: 4.435
Authors: Y H Lee; T K Kim; S I Suh; B J Kwon; T H Lee; O Ki Kwon; M H Han; N J Lee; J H Kim; H Y Seol Journal: Interv Neuroradiol Date: 2006-07-31 Impact factor: 1.610
Authors: Jong Kook Rhim; Jin Pyeong Jeon; Jeong Jin Park; Hyuk Jai Choi; Young Dae Cho; Seung Hun Sheen; Kyung-Sool Jang Journal: Neurointervention Date: 2016-09-03
Authors: Gokhan Alici; Birol Ozkan; Goksel Acar; Muslum Sahin; Mehmet Vefik Yazicioglu; Mustafa Bulut; Osman Gazi Kiraz; Ali Metin Esen Journal: Ann Noninvasive Electrocardiol Date: 2013-03 Impact factor: 1.468